Training the Obese or Overweight Client

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Every night I come home from work where I usually sit down, make a protein shake of some sort, defrag my brain for 20-30 minutes (ie: put some light jazz or classical music on the radio), and chillax. Afterwards, I’ll pop open my laptop, procrastinate, read some miscellaneous stuff, and then start sifting through emails and respond to queries from distance coaching clients and such.

After that, I’ll play catch up on any other “project(s)” I have in the works: articles, programs, or future blog ideas. Yes, my life is that exciting.

The latter, however, is what got me last night. Sometimes I’ll think of a good blog idea from a conversation I had at the facility, or I’ll read something in an article or book and want to elucidate my own thoughts on the matter. Or, much like last night, I’ll draw a blank, start hyperventilating into a brown bag, and ask for help on Facebook. Before I hit the hay last night, here’s what I left as my status update

Quick, give me an idea for a blog post!

I woke up this morning still not really sure what I wanted to write about, but thankfully, a few “friends” came to my rescue.

One idea in particular which a handful of people suggested – and it’s actually something I’ve been meaning to write about, but just never got to it – is the whole concept of how to go about training obese clients. Given the popularity of shows like The Biggest Loser (and the inevitable face palm I give myself everytime I watch an episode), I thought it would cool to jot down a few ideas.

The Anti-Biggest Loser Approach

Since this is a pretty heavy (ha, no pun intended, sorry) subject, and one that could easily turn into a full-length article, I’m going to instead write this post in list format and use more of a bullet-point approach. Basically, all I want to do here is

The most important thing you need to remember when training an obese client is that you can throw the rules out the window. I remember an article that Mike Boyle wrote on the topic not too long ago where he stated that, much to my surprise, there are a few things that he WON’T do with an obese client, namely: foam roll, static stretch, core work, and single training.

What the What???

I know it sounds like blasphemy to say the above should be omitted, especially given that they’re pretty much the staples of any well-rounded program, but here’s some rationale.

Foam Roll: for many, this will be a workout on it’s own, and will undoubtedly affect the rest of the training session moving forward. Getting up, down, then back up again is going to be cumbersome for the obese client. Moreover, and this is something I didn’t think of until Mike pointed it out, it could very well be embarrassing for the client – and that’s something you want to avoid at all costs.

Static Stretching: much like above, stretching can be problematic. And, to be honest, as much as I feel that tissue quality and health IS important – when you’re dealing with someone who’s upwards of 100+ lbs overweight, there are more pressing issues to be dealt with and prioritized. You know, stuff like not having a heart attack.

Core Work: here is where I kinda disagree with Mike (to a degree). I think much of the “core” work that obese clients will receive will come from the training in general, so there’s no inherent need to include a lot of isolated core work. That said, I do feel that exercises such as standing band pallof presses (and the like) are a valuable addition, and provide a lot of bang for their buck with regards to training obese clientele. Planks, on the other hand, not worth it.

Single Leg Work: under normal circumstances, I’d place single leg work as arguably one the most important components of a well-rounded program. But here, not so much. Think about it, if you’re working with an individual who’s 300+ lbs, that’s A LOT of weight to place on the knee joint, and it’s something that’s going to be far too challenging for them to do – maybe even dangerous.

Again, and I can’t reiterate this enough, it’s about showing them SUCCESS and not making them feel like a walking ball of fail! The last thing you want to do is have him or her perform exercises that are too hard or just plain impossible to do, because the likelihood they’ll come back is slim to none.

On that note, please, for the love of god, stop with this whole “functional training” mumbo-jumbo. Having a client juggle oranges while standing with one leg on a BOSU is NOT functional. It’s dumb, and a complete waste of time.

In its place, I’d focus more on basic movement patterns. You know, things that they’ll actually use in every day life: squat pattern, hip hinge, upper body push, upper body pull, etc. Too, it probably wouldn’t hurt to include some basic dynamic movement drills into the mix as well.

So, using a few examples, it may look something like this:

Squat Pattern: Bench of Box Squat using bodyweight only to start. In addition, don’t be too concerned with attaining proper squat depth here. Surprisingly, some obese clients will demonstrate great hip mobility with the squat; but for those who have a problem, just use a ROM that they’re able to achieve and work off of that.

***Of note: I’ve found that the TRX is a FANTASTIC tool to use when teaching an obese client to squat. By un-loading their bodyweight, you can easily “groove” an almost picture perfect squat pattern with the TRX.

Upper Body Push: Preferably, I like to use a push-up pattern here where we elevate the client on the pins of a power rack; or by using the wall. Whatever works

Hip Hinge Pattern: Depending on how kinesthetically aware they are, you can use an elevated trap bar, or, go straight up dowel rod against their back to groove the proper deadlift pattern.

If the former, again, use an elevated setting with the trap bar. If the latter, simply place a dowel rod against their backside, and make sure that they maintain all three point of contact (band of their head, middle of shoulder blades, and sacrum) as they practice the hip hinge pattern.

Alternatively, exercises such as pull-throughs and maybe even kettlebell swings – done correctly – would be an ideal option here.

Upper Body Pull: Again, this is where the TRX becomes a valuable piece of equipment as it uses their own bodyweight as resistance and can easily be adjusted to fit their current strength levels. And, of course, we could also implement exercises like standing 1-arm cable rows or band rows here as well.

Dynamic Movement: Here, we can possibly incorporate simple movement drills like high knee walks, or maybe even something like a modified yoga plex.

Also, you can include things that are more metabolic in nature like med ball circuits, or even the airdyne bike depending how much you want them to hate life (and you).

Perform above circuit for 4-5 rounds (taking as much time between exercises as needed), with 90-120 seconds of rest between each round.

Follow this with either a circuit of Kettlebell (of DB) Farmer Carries, Prowler, or airdyne work for 5-10 minutes.

I could easily keep going, but this is already getting long enough. And all of this isn’t taking into consideration the diet side of things. That’s a whole nother ball of wax.

In a nutshell, though, it pretty much gives you a basic idea of how I would go about designing a program for an obese or overweight client. It’s pretty much the polar opposite of what The Biggest Loser portrays – but I’d be willing to bet that my way will yield better long-term success without pounding people into the ground.

Have any of your own nuggets to share? Feel free to comment below!

Did what you just read make your day? Ruin it? Either way, you should share it with your friends and/or comment below.

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I love MB circuits for obese clients. They provide great movement patterning as well as some good ol' fashioned butt kickin'

Joaquin G

this sounds kinda lame but it does work with a few of my heavier clients: incline treadmill walking. most obese/very overweight clients don't do any real moving outside of what they do with me, so usually before or after their work outs i want them to stay an extra 10-20 minutes of a steep incline walk (i usually start them at 5% and work our way up to 15% over the course of a few weeks). why do i do this? just to ensure that they're actually doing the work. heavier clients either bust their butt and don't complain or look for every excuse in the book to either not take blame or look to play victim to their own decisions. it wasn't my choice to have you eat half a dozen doughnuts at work daily for 5 years….jeez. oh and obese children are the worst to work with especially when they think nothings wrong!

Myrrhis

Hey, Joaquin? I’m going to play grammar Nazi, since you seem to want to play the fitness counterpart.
Oof, I take it back. Too many errors. Hey, it wasn’t my choice to have you zone out in class for 12 years.

Chantel Hyatt

I’m sorry but I just have to say something and it may be blunt but by the way you can talk I’m sure you can also take it. So WOW if you are a personal trainer of any sort I don’t imagine a very successful one. My son happens to fall into the “oh and obese children are the worst to work with ESPECIALLY when they think nothing is wrong!” category, I knew that I had to figure away to fix this before it gets to out of control. So I start to research and find places and people who are trained in this to help as I’m also overweight and I need to change that for my own health and for my sons. And I get discouraged and lose any confidence I had once I read crap like what you have wrote. If you really don’t help build the person up from the inside you will never see results on the outside and that comes from the many years of being judge by people such as yourself with assumptions that we obese folk are just looking to “complain or look for every excuse in the book to either not take the blame or look to play victim to their own decisions.” With you just affirming all of my insecurities how would I still have motivation or drive to even try why bother right all I’am doing when I leave my training with you is “eat half a dozen doughnuts at work daily for 5 years.” If you can be this cold and inconsiderate of the fact that obese people have been told their whole life that they were fat and have had their self esteem shattered. If a person doesn’t have self worth in themselves then they will never succeed and I would hope that a personal trainer of obese clients would have the decency to do whatever they could to motivate and boost their self confidence and encourage them and assure them that up until now they were unable to succeed but with a strong support they will accomplish this goal. It’s not about making them stay extra to do a workout to prove to you that they actually managed to do some sort of exercise. Very rude and unprofessional and to think the actual blog was written for people with workout lingo knowledge and not very learner friendly for beginners taking steps to become healthy. With your ignorant post I have most certainly had all my thoughts confirmed that a trainer isn’t interested in doing anything but collecting cash.

Sad very sad I will pray for you to find the will to love yourself enough so that you can maybe spare some on your clients and really become a champion.

Rachel

I just want you to know that not all personal trainers have this point of view. Some personal trainers genuinely want to help people and make a difference. An intelligent personal trainer would know that everyone has a past and makes mistakes and would look to helping you obtain your future goals. Having someone to motivate and support you can be an amazingly powerful thing. I think you just need to find a trainer who does care about more than a pay check. They are out there! Also kudos to you for deciding to make a change in your life please don’t give up!

Ginger Snyder Morgan

Rachel, how heartwarming to know that people like you are out there! It is my fault that I’m overweight — I realize that — but I have had “help” with my weight gain with 2 transplants, a stroke, and chronic vertigo (try doing ANY workout with that!). So I, too, don’t appreciate the snarky tone. I’d love to have a PT like you who would work with and encourage me! I’m in it for the long haul.

sallie

Maybe you should re-read what they wrote…. “Heavier clients either bust their butts and don’t complain OR …” You seem to have ignored the first part of the sentence.

Harland

I concur Chantel. I feel too that comments such as those feed into a self defeating behavior that comes from many years of emotional abuse by others and a very selfish society. Hence the prayers that I would also offer. We don’t go to trainers to basic or for a lack thereof. We go to trainers because they have been in our shoes before.

Faith

The way you refer to obese people you should not be a personal trainer for them. Not all obese people eat large amounts of bad food like you insinuated, They way you spoke was horrendous and I hope you do not train obese any longer.

Andy

This is an interesting and timely blog post as I have started to wonder how to train my obese (50 lbs over ideal weight) mother.

One question I have though is how does what you said above change when dealing with older-obese clients (over 60)?

Would you implement what listed above with this population or change it? If so, how?

Many thanks, and great blog post!

mom’s to muscle

I am also a personal trainer and have worked with all sizes and ages.. Yes the older adults are the same as anyone else.. In fact depending on the level the older adult may have more challenging workouts than someone10 years younger!

Kashka

I have always seen pictures and videos, but the other day for the first time in real life I saw a trainer teaching body squat on swiss ball at 24 hr fitness. But I gotta say instead of being disgusted, I was kinda impressed, because I have tried it before out of curiosity, always fell on my butt.

Most of the people I've worked w/ could barely walk whether they had 200+lbs or not due to their ankle and hip mobility. So I use the stick, some ankle mobility and thomas test as a stretch quite a bit….just saying.

Mike A

So, are you saying that Jillian Michael's habit of standing on obese peoples legs while they do wall squats is a bad thing?

Chris Olmstead

That program looks curiously familiar to what I wrote the other day Tony. After the first session with a new obese client I tore it up and went to the veeery basics. I'm familiar with Boyle's take on training the obese clietn and ended up pretty much mimicking the exact same thing. No rolling, no ground work, a short walk after each set and modified everything. Worked like a charm.

Lewis

Nice post tony very helpful just atarted training 2 heavily obese (320pounds plus) individuals and needing some ideas. I'm glad to say I didn't foam roll but have incorporated some single leg step ups. Needless to say backs and knees were hurting. Farmers walks they love though! 5 pounds lost last week. thanks for posting this. good to know I'm on the right lines…

Tony Gentilcore

@ JB: I don't mind at all – thanks for sharing!

@ Joaquin: that's not lame at all my man. Under normal circumstances, I think it's a complete waste of a client's money to have their trainer watch them warm-up on a treadmill. But, in the case of working with an obese client, it's more often than not EXACTLY what a warm-up should be.

Tony Gentilcore

@ Andy: of course, everything is going to depend on a proper assessment. That said, much of what I touched on in the blog post pertains to most individuals regardless of age. But, of course, having the ability to REGRESS exercises as needed is important.

@ Chris: great minds think alike, eh? Boyle definitely hit the nail on the head with his original article, and I saw no need to re-invent the wheel.

“it wasn't my choice to have you eat half a dozen doughnuts at work daily for 5 years….jeez”

Is this guy freaking serious? He trains obese clients?!? I hope they read this comment demonstrating his obvious weight bias prior to hiring him.

Chris

Great post. I pretty much followed the same line of thinking when I trained larger individuals. I did a lot of push-ups in the rack, cable pushes and cable rows, neutral grip seated rows, lat pulldowns, 1-arm pulldowns with a D-handle, etc.

For the lower body, I'd actually begin with a “sit-to-stand” as my initial squat progression. I picked this up from a research study that I helped with data collection on. It's very common protocol used in knee replacement research to assess functionality. So, essentially, I'd start from the bottom and progress to performing a squat from the top down. In terms of single leg work, I'd use a modified split squat. I'd often take two bars, set the pins to an appropriate height, and create my own set of parallel bars in the rack. Then I'd have the person hold onto the bars and lower a knee down while using the bars for assistance. I did this a lot with elderly clients, too. I'd just modify the ROM by placing a mat under the down knee depending upon the client.

I'd also do a modified, body weight only single leg RDL by making is more of a “functional reach” exercise. So, I'd have them stand just far enough away from a railing or maybe a bar in a rack and reach to it on one leg and then stand back up. Of course, I was spotting them entirely and following them through each rep. This is also great for older folks and ultimately just helps them to improve their coordination, stability, and general movement.

I also used suitcase deadlifts a lot, but I'd use a very light dumbbell and often stack the weight up high enough to keep the ROM of manageable for them. Again, this also works very well for older individuals, too. Often, they have no idea how to hinge and bend down properly.

Honestly, I think with obese people, it's a matter of just following the principles of good movement and making modifications. The same is true for the elderly. They are always so amazed when they go…”When am I going to do some real exercises?” and then I show them the advanced versions of what they are really doing. The art of progression is such a beautiful thing!

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jem

I think some people try to be all like oh biggest loser does this wrong and that wrong but if you actually watch it from a persons point of view that is or has been in this situation eof being obese you may see things slightly different. I have and watching this show you can gillian and the other trainers push the contestant but then those contestant start to trust the trainers, start to let barriers down and the realization of why and how they became overweigth is revealed. These barriers overweight people have are so hard to break and pushing them until they breakdown seems harsh but tthese trainer care and are prepared to say and do what their loved ones aren’t to help them change their lives. Dont judge if you haven’t gone through the weight loss journey!

Jovan

Great read! I will be training an obese client for the first time and I found this very useful.

TonyGentilcore

Glad it helped Jovan.

Jen Williams

Hi Tony. I am a obese person and will soon be looking for a trainer. I started at 373 and with nutricion alone I am now down to 340.6. I am eating at about 95% clean and I am very motivated and feel it is time to start a training program. With that said what tips do you have for the obese client when choosing a trainer who will use the methods described in this post? I would like a combo of cardio but more focus on lifting to increase muscle mass for more fat burn overall. I am female and 5’8. Any advice is welcome and appreciated with the exception of the guy who made the doughnut comment LOL. Thank you in advance for your time.

TonyGentilcore

Hi Jen –

Thanks for reaching out and CONGRATS on your success! It seems like you’ve already gotten some good momentum moving forward.

I don’t feel there’s any real criteria here, although I do have some candid thoughts:

You should interview THEM. Ask them questions like are they certified, how long have they been training people, do they have experience training someone with a similar background as yourself?

Do they actually take you through an assessment?

Tell them what YOU want – you’re the one paying for their services, and if their philosophy doens’t match yours, can they refer you to someone who’s a better fit?

Good luck!!

Carla Sizelove

Great article! I really like how you put the client emotional, physical health in consideration. I have seen so many, push clients thru impossible workouts that tore them down, instead of lifting them up.

TonyGentilcore

Thanks – glad you liked the article Carla!

FitLadyDi

I only began to read this when I saw you use the word “retarded” as a negative adjective. Please try not to do this, as it really doesn’t serve any good purpose to put down a population of mentally handicapped people when you are trying to help physically challenged folks…

TonyGentilcore

You’re right FItLadyDi….and not that it’s an excuse, I did write that article 5-6 years ago. Admittedly I was a lot more immature then. I didn’t even know how to use a salad fork then.

But you’re correct. It hasn’t happened since, and your note serves as a nice reminder that I need to go back and change that.

Beth Curtis

I’m a certified trainer through ACE and I agree about biggest loser lol. Thanks for the article. Came on to get some fresh ideas for a client I’m working with. My complication is that my client is pretty fit but she has diabetic neuropathy in her feet. One thing i do implement as well are the weight machines. they have been a good way to incorporate strength training with her limitations (ex nautilus leg and chest press). Thanks for the ideas.

I am an obese client and this has helped me tremendously. I used to be in excellent shape but over exercised (8 miles a day/12 miles on the weekends and ended up with 2 knee replacements. Due to a job commitment for the last two years I wasn’t able to exercise or do much physical activity and put on over 80 pounds and am now tipping the scales at 300. Four years ago I had a fall that tore four of my hamstrings and am still struggling with that. I recently switched jobs and rejoined my health club and have been working out with a trainer for the last two weeks but after yesterday’s training I was in extreme hamstring pain; and hand pain (i have arthritis in my hands) from doing planks. My brother wants me to put training on hold and get into the pool for a month or two before resuming. I feel as if my trainer takes me from 0 to 60 when I see him and my body is paying a price: PAIN. It takes a long time to recover, too. I see him at 5am and when I get home I have to sit for at least 30 minutes to recover. We are going to talk about it tomorrow but reading your article has helped prepare me for that talk. Thank you!

TonyGentilcore

Glad it was of some help and it resonated with you. Hope your meeting with your trainer went well.

Michelle Rose

Thanks! Yes, he was totally open to what I was saying and has backed down a bit and I am more verbal about telling him if something hurts. I’ve also started swimming again and that is helping tremendously.

Jill

Great post. I have my first client as a trainer starting in a week No exercise ever 295lb. This give me a little more confidence going into our first session.

Jill

Great post. I have my first client as a trainer starting in a week No exercise ever 295lb. This give me a little more confidence going into our first session.

I’m little late to this conversation but I’m curious…..why not planks?
And… do you still feel this way?

Tony

Yeah, I wrote this something like 7-8 years ago. I think planks are “okay.” However, with the obese client, who likely already has a hard enough time as it is getting up and down off the floor, I’d rather focus on things that don’t shed the spotlight on that so much. Farmer carries, Pallof Presses, anti-rotation chops and lifts (which can all be done standing) will almost always be a better way at demonstrating success and are better than planks if you ask me.